The arduous relationship between sheriff’s offices and those committed to the state for mental health issues is only becoming more taxing, according to Macon County Sheriff Robbie Holland.

“What we’re seeing this year is a significant increase across the board in all aspects of our portion of the mental health system, which basically relates to the transport, care and custody of involuntary commitments,” said Holland during his department’s budget request meeting last month to county commissioners. This year’s request was an increase from last year’s, though it was lower that the fiscal budget of 2009.

“The increase can be primarily attributed to the minimal control that we can do over the mental health system,” said Holland of MCSO personnel hours spent keeping watch on such cases.

But what are involuntary commitments? Holland explained at the meeting that such commitments are a judicial order passed down from the magistrate’s office which essentially revokes a person’s civil freedoms. At that point, the person is then taken into custody until they are accepted by a proper mental health facility. The problem is that sometimes it can take days for that person to be properly placed for treatment.

In the case of the sheriff’s office, a deputy must sit with the involuntarily committed person. “If it’s a female two officers have to sit with that person,” said Holland, adding that often the county is paying time-and-a-half for an officer to transport a patient.

“What we’re talking about here, gentlemen, is an increase that is unprecedented,” said Macon County Commissioner Ronnie Beale. The moment a magistrate signs such an order, that patient is then the responsibility of the county—more specifically, the sheriff’s office.

“The greater issue for us is, it’s not like it was in 1984 where we picked up a person, took them to the hospital to get evaluated and bring them to Broughton [a mental health facility],” said MCSO Major Andy Shields. “Now we pick them up, take them to the E.R., and 343 hours later, we take them to Broughton.” “It’s not so much the commitment or process itself, it’s the wait time.”

The MCSO is looking at a 72 percent increase in the rate of commitments this year and a 15 percent increase in the number of officers needed to process a transport.

According to recent reports by Macon County Emergency Services, a male involuntarily committed last Sunday escaped from the custody of Angel Medical Center while he awaited transport to a proper mental health facility. Shortly after his escape, 15 to 20 deputies surrounded the area and eventually were able to take him back to the hospital.

“It’s not getting any better,” said MCSO Staff Attorney Brian Welch, who recalled the incident as an example of the issue.

Shields projected that this year, the MCSO will care for approximately 120 patients, an increase of 20.

At the end of the day, Beale explained, it’s difficult to find a facility to take a patient due to the man hours required to treat them. “It’s a real problem,” he said.

But what’s worse, say authorities, is voluntary commitments have been all but eliminated. “A voluntary commitment is when I realize that I need help and went and asked for it,” Shields said as an example. “The hospital or the magistrate’s office would then get me the help that I needed.”

“You and your family are then responsible for getting you transported,” said Holland. Now, he explained, there is no such policy, and everything is involuntary, laying more burdens on the county and state to not only process and find a person a facility, but also transport them and watch them.

Beale said that with Macon deputies now NAMI trained, the burden has been lessened to some degree. “What that does is it teaches those officers, when they go into that situation, how to better handle and calm that situation down.” Also, officers trained in the program are given contact information for various resources throughout the state to help them find treatment.

This year, Holland said, the MCSO would do its best not to ask for an increase in funds to deal with the issue.

When asked whether MCSO had any part time officers to help with transport, Holland indicated that the department has already been using them as a resource. “The problem is that we have so many involuntary commitments, sometimes we will have three or four involuntary commitments at the same time at the hospital.” He added that sometimes officers will go as far as the east coast of the state to transport a patient.

Since January, more than 2,000 hours have been spent by officers to sit with involuntary commitments while they await treatment, which translates to more than $47,000 in wages. Last year, more than 1,900 hours were spent by officers during the entire year, with a total county wages expenditure of approximately $44,000.